![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 33. This is the beginning of the thread.
Posted by uncouth on December 22, 2009, at 18:23:11
Things are getting bad again. I don't know if it's the holidays, the major and minor rejections i've been getting the last few weeks ,or the quitting smoking. Probably a combination of the three. But my complex drug regimin that kept me out of suicidal-land for the last 2 months isn't doing the trick anymore. I am resisting an urge to smoke but damn do I want one now.
My regimen I feel did a good job of taking away the constant, throbbing negativity and depressive pain. But it did nothing for the lack of positive affect or hope or optimism. That has been gone from me for so long, so very long.
I guess the point of this post is two fold. Are there any medications that help with rejection sensitivity? Are SSRIs good for that? Right now I'm not on one. I know it's part of the atypical depression constellation, but after getting stabilizied for a few months, I am exquisitely sensitive -- any small rejection or disappointment sets off a big mood reaction.
Secondly, what to do about the lack of positive affect. Anything? I'm already on a high dose of wellbutrin. Optimism, fun, excitement...nothing...i feel none of it and haven't for so long.
God saved me this summer from taking my life. I was close, very very very close. ECT didn't do it, drugs didn't do it, the pain I was in was so intense and so refractory to treatment that the only way I can understand how I got through it was through God. And note my faith was weak during that time too.
But now I feel unmoored, dangling, with no, zero, zilch hope for the future, no ideas of how to get some, and feeling trapped, drowning, pummeled by life's barbs. Not being able to handle even the most simplest and benign disappointments and failures. It just never ends, and the worst part is I know the more time I spend in this state, the more pains I take, probalby the more difficult it is to rise above and out.
God please help me again get through this. I don't know what's on the other side, but you saved me once please save me again.
-uncouth
I'm on zyprexa, abilify, tianeptine, high dose wellbutrin, memantine, sam-e, deplin, and tapering off of lithium
Posted by Roslynn on December 22, 2009, at 19:05:25
In reply to Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 18:23:11
Hi Uncouth,
We have not exchanged messages before but I wanted to say, please do not give up hope. I myself was in a bad state the other night but it has largely abated. So you can feel better.
There is a number on the DBSA card. it says you can call 800-442-HOPE. Please call that number, or another crisis number or reach out to one of your emergency contacts.
Posted by inanimate peanut on December 22, 2009, at 19:13:53
In reply to Re: Rejection sensitivity and I want to die again, posted by Roslynn on December 22, 2009, at 19:05:25
Sorry that you're feeling that way. I'm super-sensitive to rejection right now as well. Just try to remember that it's a symptom of your depression and not who you really are. Use this board or call hotline for support. There's a whole Social board (link on bottom of page center) that people will be happy to accept you and talk with you. Maybe you should try that?
Posted by conundrum on December 22, 2009, at 19:37:20
In reply to Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 18:23:11
I know smoking is bad, but sometimes trying to quit when a lot of other hard things are going on isn't the best timing. If you find this season stressful smoke and wait til its over and you've found other drugs that may help.
When I was on Prozac I wasn't so sensitive to rejection. In fact I was a bit arrogant. Also it wouldn't make sense to take tianeptine and an ssri together, because they have opposing actions, in fact it might be a bad combo.
Posted by linkadge on December 22, 2009, at 19:38:50
In reply to Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 18:23:11
>I'm on zyprexa, abilify, tianeptine, high dose >wellbutrin, memantine, sam-e, deplin, and >tapering off of lithium
whoa dude - I think you need to simplify things. Whats your digansosis anyway? (treatment reisistant depression?)
Your regiment is very weird and self defeating in a number of ways.
Observation #1 you are really doing some weird things dopaminergically
Observation #2 the combination of serotonin antagonists (AP's) and tianeptine might really accentuate rejection sensitivity.
I would say pick *two or three* of the above meds which you really *know* help (ideally fewer serotonin antagonists). Then add something serotonergic.
Linkadge
Posted by ace on December 22, 2009, at 20:02:03
In reply to Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 18:23:11
> Things are getting bad again. I don't know if it's the holidays, the major and minor rejections i've been getting the last few weeks ,or the quitting smoking.
I would say a combination of all three, however, do not underestimate the smoking cessation to be playing a major role in undermining your sense of well-being. However, I wouldn't think these would last much beyond 14 days or so.
What rejections have you recieved?
Romantic, business, general social?Probably a combination of the three. But my complex drug regimin that kept me out of suicidal-land for the last 2 months isn't doing the trick anymore. I am resisting an urge to smoke but damn do I want one now.
How did you stop? Did you use 'substitutes' or 'cold turkey'?
Have you got other people around you supporting your efforts?
I would advise reading a fellow named Allen Carr, who did a great deal in helping people stop smoking.
>
> My regimen I feel did a good job of taking away the constant, throbbing negativity and depressive pain. But it did nothing for the lack of positive affect or hope or optimism. That has been gone from me for so long, so very long.Well your regime, in my opinion, is simply not good enough.
>
> I guess the point of this post is two fold. Are there any medications that help with rejection sensitivity? Are SSRIs good for that? Right now I'm not on one. I know it's part of the atypical depression constellation, but after getting stabilizied for a few months, I am exquisitely sensitive -- any small rejection or disappointment sets off a big mood reaction.Firstly, and I emphasis this is only my opinion, I would stay clear of the SSRI's. I would much rather use MAOI's, TCA's, or benzo's. Is this rejection sensitivity part of a social phobic problem? If so, go straight to Nardil or Xanax, Clonazepam etc
However, I would try and work on the fundamental beliefs behind this rejection problem. I am not a big fan of psychotherapy, but I think CBT does help this disorder. And I don't think it is necessary to see a psychotherapist.
As a youngster, through whatever way, you probably got some idea in your head that you were somehow inherently flawed or 'different' to others...that you were not as good as others. The same people you fear rejection from, may actually fear it from you! Think about that deeply, and meditate on it.
The problem is, is that you may be running around with these beliefs you acquired so many years ago, which simply have no validity. They only have validity by virtue of the fact that you are giving them validity!
Who are these people to have such power over you?
Be honest, do your best, and they can take it or leave it!
Do NOT ASSOCIATE THE REJECTION WITH WHO YOU ARE!
> Secondly, what to do about the lack of positive affect. Anything? I'm already on a high dose of wellbutrin. Optimism, fun, excitement...nothing...i feel none of it and haven't for so long.I don't have much faith in these new drugs at all. I have never seen any evidence that they are more efficacious than the TCA's, MAOI's. Actually most evidence I have seen, shows them to be LESS effective, have MORE withdrawal problems. But the poor psychiatrist is fed the data that the drug companies want him/her to read!
>
> God saved me this summer from taking my life. I was close, very very very close. ECT didn't do it, drugs didn't do it, the pain I was in was so intense and so refractory to treatment that the only way I can understand how I got through it was through God. And note my faith was weak during that time too.Turn to this faith again.
> But now I feel unmoored, dangling, with no, zero, zilch hope for the future, no ideas of how to get some, and feeling trapped, drowning, pummeled by life's barbs. Not being able to handle even the most simplest and benign disappointments and failures. It just never ends, and the worst part is I know the more time I spend in this state, the more pains I take, probalby the more difficult it is to rise above and out.I am sure a lot can empathise here with you, and I don't say that to undermine the pain you are experiencing. It seems you feel you are trapped, and feel helpless to circumstances around you....What you describe here sounds like a pathological state. Certainly not a 'normal' sadness.
In your situation I would first get the medication situation sorted.
If you have any suicidal ideation, you must tell others and get to a point, via medication, where you can feel that you have some free 'space' from your depression to apply your own efforts.
> God please help me again get through this. I don't know what's on the other side, but you saved me once please save me again.Keep writing here too mate, we are all on your side.
> -uncouth
>
> I'm on zyprexa, abilify, tianeptine, high dose wellbutrin, memantine, sam-e, deplin, and tapering off of lithiumThis is a lot of medications!
What is the official diagnosis?Whatever the case, your current mental state does not warrent the continuation of such a regime.
You are having interactions all over the place, and they could be actually contributing to your depression.
I have seen this again and again. One drug isn't working - stick him on another....and another...and another!
I'm not against polypharmacy, but I am against the psychiatric neglicence.
You don't know what is doing what when your own so many.....
I think maybe just taking one or two may do just as good....
Hang in there mate, and get back to me....
Ace
Posted by ace on December 22, 2009, at 20:03:54
In reply to Re: Rejection sensitivity and I want to die again, posted by linkadge on December 22, 2009, at 19:38:50
> >I'm on zyprexa, abilify, tianeptine, high dose >wellbutrin, memantine, sam-e, deplin, and >tapering off of lithium
>
> whoa dude - I think you need to simplify things.Simplify- that is the word I needed!
Well put Linkadge!
Posted by uncouth on December 22, 2009, at 20:23:10
In reply to Re: Rejection sensitivity and I want to die again » linkadge, posted by ace on December 22, 2009, at 20:03:54
THanks all for the helpful comments.
The rejection is a combination of relationship (women), jobs ( can't get one), social, and business, and getting rejected from 2 out of the 6 business schools I applied to (and probably will get rejected from the rest too despite my objective qualifications).
I am really tired of my life. I know that might be vain, stop thinking so much about it and just LIVE your life. So many people out there are thrust into situations they ahve no control over and make the best of what they're given. But I feel like I'm supposed to do so much more, the sense of failure of squandering so much and of continuing to just 'screw it up' is so profound for me.
Yes, I know my medication stuff is complex.
Zyprexa has helped for sure, and the low dose abilify is on top to prevent weight gain, which it has done.
Wellbutrin is the primary a/d, and i'm taking 600mg. It got me out of the deepest pit so it is staying.
The tianeptine is a more recent experimental addition...going to give it a month to see if it does anything useful. I am attracted by the science and its theoretical usefulness...but whether that translates into efficacy for me remains to be seen.
In the past I have responded, but a little TOO well, to SNRIs. I am bipolar 2, and on average spend about 2 weeks out of the year in a mildly hypomanic state, but a state in which I do do things I regret and say things I regret. So I am a bit concerned about adding an SNRI, at least at a high dose.
I've tried emsam, parnate, nardil, clomipramine, nortryptiline. Emsam and Parnate for long term. Both caused significant dysphoria and anxiety...head was spinning all the time. But never tried them with zyprexa which might make the difference. Clomipramine and nortryptiline knocked me out and caused severe fatigue.
I am going to slow down on the lithium withdrawal and maintain myself at 300mg per day until I get through the worst of the smoking withdrawal and hopefully these feelings of rejection and suicidality subside.
Thank you for your wishes. IT's tough to not experience the joyfulness of the season. Bless you all.
Uncouth
Posted by hyperfocus on December 22, 2009, at 20:29:58
In reply to Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 18:23:11
These are tough times for people like us. All I can suggest is that there is a feedback loop where minor rejections may trigger ruminations which themselves trigger ruminations till you're right down at the bottom of the black it. If you can recognize this cycle then just let it be for now. You may not have enough strength to start countering it, but just recognizing it is important.
Take it easy, the solution is there but it may not be grasped imeediately. If there's something that gives you comfort (even smoking) I would just do it and worry about it when you're better. I'm pretty sure depression kills more people than short-term smoking. You still have a lot of life in you, just take it easy and try to get on the right meds.
Have you ever been on Nardil?
Posted by conundrum on December 22, 2009, at 20:36:08
In reply to Re: Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 20:23:10
Good luck. I can't find a job either. I know that doesn't help you but it really is the economy and you have to know someone to get a job these days. I've heard that from recruiters.
I don't think this season is usually too joyous unless your under 13 years old. ;-)
Posted by ace on December 22, 2009, at 20:57:33
In reply to Re: Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 20:23:10
> THanks all for the helpful comments.
>
> The rejection is a combination of relationship (women),What's the problem here?
Have you ever worked on something like rejection practice...your aim is to be rejected.... Can really desensitize you!
It pertains mainly to rejections within the romantic realm, however.jobs ( can't get one), social, and business, and getting rejected from 2 out of the 6 business schools I applied to (and probably will get rejected from the rest too despite my objective qualifications).
Get all this stuff down in pen and paper, see exactly where you want to go, what you want to get. Accept the rejections if they come. Don't foresee them but. And don't ever associate them with who you are.
> I am really tired of my life.I know that might be vain, stop thinking so much about it and just LIVE your life. So many people out there are thrust into situations they ahve no control over and make the best of what they're given. But I feel like I'm supposed to do so much more, the sense of failure of squandering so much and of continuing to just 'screw it up' is so profound for me.
Here I can see that your equating your self-esteem, your value, with what you do in life.
I am guilty of this too, I think we are all to a certain extent. As we get older I think this mindset dissolves naturally but.
You talk about other people....don't worry about them. You are YOU! don't compare...you have your road in life, they have their's.
Practice these ideas, see how they feel.....
when you 'screw-up', if you feel you do....say 'so what'!!!
> Yes, I know my medication stuff is complex.
>
> Zyprexa has helped for sure, and the low dose abilify is on top to prevent weight gain, which it has done.I would never advise using an antipsychotic to prevent weight gain. With weight gain, I would try the obvious first- diet and exercise. After a while, if the weight is still posing a big problem, then try some other agents.
But this business of using an antipsychotic to mask the weight gain of another antipsychotic....I just personally feel you may be having more problems 'cause of this. Abilify is noted to cause akathisia at even low doses.
> Wellbutrin is the primary a/d, and i'm taking 600mg. It got me out of the deepest pit so it is staying.How long have you been on this for?
Have you tried Carbamazepine?
Who is currently handling your pharmacotherapy?
Shrink, or a GP?
Posted by floatingbridge on December 22, 2009, at 21:43:32
In reply to Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 18:23:11
Uncouth,
I'm sorry to hear you are having a rough time, and glad to see you get so much response to your post.
Lots of folks here are pulling for you.
Holidays are major stressors--they really are. For rejection sensitivity, therapy helps me. Others here are better able to address the med issue--ssri's used to help....(I also think quitting smoking is a big deal, esp if you've smoked for awhile--please don't underestimate it or all the other legitimate stress in your life.)
fb
Posted by uncouth on December 22, 2009, at 21:53:08
In reply to Re: Rejection sensitivity and I want to die again » uncouth, posted by ace on December 22, 2009, at 20:57:33
experienced pdoc is handling my psychopharmacology. and i help too:)
ace thanks for the post.
i am in a haze right now but it was good to read.
i am a jumble of regrets, hopelessness, apathy, anhedonia, more regrets, sensitivity, loss, worry, fatalism, despair. i feel like someone cracked me and im being scrambled on a hot griddle. all the parts of me are being disassociated -- literally falling apart. how in the world is life this hard.
i have squandered so much. 2 degrees from stanford! and yet, living at home, age 29, with parents, no job, no love -- for anyone, from anyone, for myself, from myself.
i look in the mirror -- I CANNOT BELIEVE that is me looking back, and the situation i am in. the hopelessness and feelings of failure...so profound.
my life, it feels like many lives. does this make sense? i look back, elementry school, high school, college, after college, job, the present...they are all fragmented...memories feel like they are lifetimes ago. no sense of continuity, the only thing constant is this pain i've had with me since i was a boy. i hated it when my dad came home smelling of alcohol slurring his words. and he still does it, except i'm 20 years older. but i feel the same.
oh and when i think about what i lost. i was SO CLOSE. i had it all just 2 short years ago. job, woman. and it disappeared, i let it slip through my fingers. blamed the depression. but who knows. all i know is i was hating life and couldn't seal the deal on anything.
now i'm struggling...to say the least. go to sleep at 7.30pm everynight. tv doesn't entertain me...all i see is other people living their lives and i look and say wow it looks so easy for them...whats wrong with me. WHATS WRONG WITH ME!!! what hath God wraught?
these sufferings are so profound, so prolonged, and yet, i don't hve to feel the pain of a lost spouse, or dead child...soem people have so much more to deal with every day. who am i to complain? but...it still hurts. people don't understand. brain is like any other organ...it can malfunction right? independent of any other circumstance.
sh*t f*ck sh*t i'm on so many meds and i dont even know whats real anymore. but i can't throw them away, because then what. then what???
i was a Golden CHild. Smartest in the class, in the neighborhood, in the school. So much potential. And now look at me. Thats what i fear people say about me now "oh he had so much potential, it's so sad". how pathetic. and i agree with them.
i want it all to end. this isn't what i signed up for. why does God let children be abused? alcohol, physical, psychological, sexual, whatever, it's all damaging -- for life. where are you God, i'm angry and don't understand. i've cried out to you, are you listening?
we the mentally ill are given the secret knowledge of suffering. ican't look into the face of a homeless person, someone impoverished, or sick, without feeling empathy now. this has changed me. maybe this is how Jesus felt? the meek inherit the earth....
Time for bed. Maybe tomorrow will be better. Probably won't, probably will be another wasted day, another day of torment of my own making, another day filled with punishment...WHY am I being punished what have I done? I've been punished since I was a child like this! Have I always been guilty? Lord, why???
-uncouth
Posted by emmanuel98 on December 22, 2009, at 22:06:34
In reply to Re: Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 21:53:08
Do you see a therapist? It really sounds like you get caught up in intensely negative self-talk. I used to have the same issues -- I'm not good enough, I'm a failure -- and therapy really helped me with that.
Posted by Phillipa on December 23, 2009, at 0:06:56
In reply to Re: Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 21:53:08
Uncouth hang in there with us just saw this and I'm behind you. You made it before and I'm positive you will make it again. You know I'm 63 yes getting old but you know what? I'm a fighter and I will live to be 120 years old. Why cause in nursing school had to write our own death and I'm sticking with this plan. As for the smoking wait now isn't the time as smoking does have chemicals that help some. And as the others say keep writing and let us listen and hopefully help. I care for you and haven't ever met you. Please try? If you can do it I can. And the Holidays to me really are for children and adults just get caught up in thinking I should be better or be someone else. I like you. Can you like you? It's Hard I go through this also. Fight. And you will win. Love Phillipa
Posted by ace on December 23, 2009, at 3:16:48
In reply to Re: Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 21:53:08
> experienced pdoc is handling my psychopharmacology. and i help too:)
Well, I am at a loss for some of the drugs he has put you on.....I couldn't say why unless talking to him.
> ace thanks for the post.Thant's OK!
>
> i am in a haze right now but it was good to read.
>
> i am a jumble of regrets, hopelessness, apathy, anhedonia, more regrets, sensitivity, loss, worry, fatalism, despair. i feel like someone cracked me and im being scrambled on a hot griddle. all the parts of me are being disassociated -- literally falling apart. how in the world is life this hard.
> i have squandered so much. 2 degrees from stanford! and yet, living at home, age 29, with parents, no job,I think that if you had 200 degrees from Standford, you still would be at a loss!
It seems you are comparing yourself again to societal 'norms'. Believe me, societal 'norms' are not always healthy!
Like I was saying, live your life according to you, regardless of what society or others say is right.
Their is nothing wrong with living with your folks at 29, and having no job is not the best, but, I state again, don't associate the negativity of this with who you are as a person.
no love -- for anyone, from anyone, for myself, from myself.Work on that. You know, pretend that you are a loved one, or a friend who is very ill in hospital. Treat yourself as you would treat them. Practice this but- a lot!
Then start trying to love others, and help others....without expecting anything in return.
But all this stuff takes practice.
> i look in the mirror -- I CANNOT BELIEVE that is me looking back, and the situation i am in. the hopelessness and feelings of failure...so profound.
>
> my life, it feels like many lives. does this make sense? i look back, elementry school, high school, college, after college, job, the present...they are all fragmented...memories feel like they are lifetimes ago. no sense of continuity, the only thing constant is this pain i've had with me since i was a boy. i hated it when my dad came home smelling of alcohol slurring his words. and he still does it, except i'm 20 years older. but i feel the same.
>
> oh and when i think about what i lost. i was SO CLOSE. i had it all just 2 short years ago. job, woman. and it disappeared, i let it slip through my fingers. blamed the depression. but who knows. all i know is i was hating life and couldn't seal the deal on anything.
>
> now i'm struggling...to say the least. go to sleep at 7.30pm everynight. tv doesn't entertain me...all i see is other people living their lives and i look and say wow it looks so easy for them...whats wrong with me. WHATS WRONG WITH ME!!! what hath God wraught?All these things you are saying here: I really feel they are just being magnified by your current condition. When I hit rough patches, I think "What mistakes, what a sad life!"
Then when I am happy, I think "Gosh, life is working out for me exactly as it should- even the bad parts!"
It is like you are looking at your life through these bleak dark magnifying glasses created by your depression...
> these sufferings are so profound, so prolonged, and yet, i don't hve to feel the pain of a lost spouse, or dead child...soem people have so much more to deal with every day. who am i to complain?Pain is proportional and totally subjective. You have every right to experience your pain, and we can not quantify it, in relation to others pain.
but...it still hurts. people don't understand. brain is like any other organ...it can malfunction right? independent of any other circumstance.
Yes! Unfortunately we have no biological markers for any psychiatric disorder, but I have no doubt of the authenticity of aberrant brain function causing psychiatric disorders.
> sh*t f*ck sh*t i'm on so many meds and i dont even know whats real anymore. but i can't throw them away, because then what. then what???I do advice that you get down to 2 medications. You ARE on a lot now, and, as stated before, I think this is likely to be causing problems for you. Including the 'hazey' feeling you mentioned.
> i was a Golden CHild. Smartest in the class, in the neighborhood, in the school. So much potential. And now look at me. Thats what i fear people say about me now "oh he had so much potential, it's so sad". how pathetic. and i agree with them.Stuff other people. Practice living by your standards. By your values. Really cultivate this.
> i want it all to end. this isn't what i signed up for. why does God let children be abused? alcohol, physical, psychological, sexual, whatever, it's all damaging -- for life.I can't answer this. I have a some strong ideas about this, but, alas, I would need to write an essay to try and approach this qstn!!
where are you God, i'm angry and don't understand. i've cried out to you, are you listening?
> we the mentally ill are given the secret knowledge of suffering.There is a blessing bestowed on us, i feel. But it can take years and much pain to fully appreciate this.
ican't look into the face of a homeless person, someone impoverished, or sick, without feeling empathy now. this has changed me. maybe this is how Jesus felt? the meek inherit the earth....This is a wonderful attitude.
> Time for bed. Maybe tomorrow will be better. Probably won't, probably will be another wasted day, another day of torment of my own making, another day filled with punishment...WHY am I being punished what have I done? I've been punished since I was a child like this! Have I always been guilty? Lord, why???
>
> -uncouth
Just DON'T YOU GIVE IN MY FRIEND!Onwards brave soul!!!!!!!!!
Ace:)
Posted by ace on December 23, 2009, at 3:18:18
In reply to Re: Rejection sensitivity and I want to die again, posted by emmanuel98 on December 22, 2009, at 22:06:34
> Do you see a therapist? It really sounds like you get caught up in intensely negative self-talk. I used to have the same issues -- I'm not good enough, I'm a failure -- and therapy really helped me with that.
I agree. But why can't people institute their own psychotherapy?
Buy a book on CBT and be their own therapists.
Posted by ace on December 23, 2009, at 3:20:26
In reply to Re: Rejection sensitivity and I want to die again » uncouth, posted by Phillipa on December 23, 2009, at 0:06:56
You know I'm 63 yes getting old but you know what? I'm a fighter and I will live to be 120 years old.
What an AWESOME attitude!!!!!
I think this is great Phillipa!
Ace:)
Posted by Sigismund on December 23, 2009, at 3:57:37
In reply to Re: Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 20:23:10
Alex, you were the one who signed your letters 'love Alex'.
That's a bit of positive affect.
Americans (coming from the protestant thing) worry a lot about failure.
You could take the opportunity of enforced idleness to read (Russian novels maybe).
2 degrees from Stanford and you're only 29?
As you have implied, depression can make you a better person.
Posted by SLS on December 23, 2009, at 5:31:16
In reply to Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 18:23:11
> I'm on zyprexa, abilify, tianeptine, high dose wellbutrin, memantine, sam-e, deplin, and tapering off of lithium
Basically, I agree with the other posters.
Abilify might be antagonizing some of the anti-suicide properties of Zyprexa. S-AMe produced an anxious dysphoria for me. Memantine made me feel better during the first week, but worse thereafter. Deplin produced an improvement initially, but ended up being inert. This might not be the best time for you to discontinue lithium, unless it is somehow affecting you negatively. If you are taking more Wellbutrin than what you really need, perhaps it is contributing to causing an anxious state.
Psychiatry has considered SSRI drugs to be effective for treating atypical depression. The same is true of MAOIs, particularly Nardil. Tricyclics and Wellbutrin seem to be of little value. I don't know about Remeron or nefazodone, however, I have never seen anything indicating that they are particularly helpful. I would guess that Effexor and Cymbalta have some efficacy in treating atypical depression.
It looks like you need to make some major changes in your treatment regime before you begin to feel better. In the meantime, psychotherapeutic approaches can help to place your thoughts and feelings into perspective, and give you coping tools to use while you are searching for effective somatic therapies.
I really hope you feel better soon. I know what it is like to fall into the abyss. It seems as though there will never be an escape from the blackness. At times like this, I find it helpful to recall the times when I felt better and know that I can feel like that again. Doing so can bring hope and avoid thoughts of suicide.
You are not doomed.
Ok, now it's your turn. You need to say these things back to me because I am in a bad place, too. Sometime, things gang up on me - bad biology, bad situations, bad thinking.
- Scott
Posted by linkadge on December 23, 2009, at 8:49:08
In reply to Re: Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 20:23:10
>and getting rejected from 2 out of the 6 >business schools I applied to
Well, don't jump to conclusions.
I am just not a fan of the drug combinations. The toxicity of many of these meds is likely worse in combination. How a drug affects you alone is not necessarily how it will affect you in a drug combo.
For instance, a study showed that the oxidative stress induced by sertraline in neural tissue was magnified several fold by the addition of valproate.
There is a tendency to cling to medications and collect them, even if they are not doing you any good. Many people get better by coming *off* medications.
I too once was on about 6 medications (celexa, epival, clonazepam, zyprexa, lithium, cogentin....oh plus SAMe). I was in and out of the hospital for years.
Right now, omega-3 stabilizes most of my moods. I add in some taurine and magnesium as needed if I get too out of control. My only medications are methyphenidate and amitriptyline (10mg) when needed for sleep.
Posted by linkadge on December 23, 2009, at 9:03:49
In reply to Re: Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 21:53:08
I am the same way in that, I can enjoy nothing unless I feel worthwhile. This fall has been good for me in that I actaully did get a job. A job can make a *big* difference.
Dude, take small steps. Find some sort of job that uses at least some of your skills and abilities. Get some help from disability employement programs - seriously. They can connect you with a job that will pay and be understanding of your situation. Somebody with your abilities just needs an opportunity and a reason to get better. I don't necessarily mean go out and get a McJob, but with your qualifications and a disabiltiy consusltant, you should be able to find meaninful (perhaps part time) work that at least makes you feel worthy of getting up in the morning.
Don't worry about what people will say you "might" have been. Its "The Power of Now"
which BTW is a good book.Linkadge
Posted by linkadge on December 23, 2009, at 9:16:09
In reply to Re: Rejection sensitivity and I want to die again » uncouth, posted by SLS on December 23, 2009, at 5:31:16
Part of what has been instrumental in my recovery has been the addition of a stimulant.
I was first diagnosed as having depression and put on an SSRI. The SSRI everntually made me more impulsive and gave me mood swings. From there I was led down the bipolar route (which can be a extremely nasty route). Bipolar meds can be extremely impairing esp in combinations. I took an extra 2 years in university just trying to sort medications out. I too was very high functioning before mental illness struck.
Anyhow, to make a long story short the bipolar diagnosis was reconisdered and I was put on a stimulant. The stimulants quite simply act as mood stabilizers for me.
After the addition of ritalin, I've noticed my brain works more in a linear fashion. It quells certain anxieties and seems to give a better ability to plan long range. It also (for me) appears to have some prophylactic effect against reccurrent depression.
Most importantly, it is a hell of a lot better on my cognition and affect than AP's (or even AD's).
Posted by janejane on December 23, 2009, at 11:27:15
In reply to Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 18:23:11
I don't know that I can add many new or helpful suggestions, but I did want to offer my support to you, Uncouth.
Maybe you don't feel like you're living up to your potential right now (I know that feeling all too well), but you've also got huge obstacles that most people don't have to deal with. Be proud of yourself for achieving what you have so far (probably more than most do in a whole lifetime), and remember that you're young enough to accomplish a great deal more before you're done.
I'm going through a tough time right now too, and I'm sure everyone here has struggled with their own demons at one time or another. Try to remember that we're in good company, as many of the coolest historical figures had problems like us. Fortunately, we have better meds available today. Hopefully you'll be able to find a combo that works for you. It sounds like you are getting some good suggestions in that regard.
Posted by bleauberry on December 23, 2009, at 18:42:58
In reply to Rejection sensitivity and I want to die again, posted by uncouth on December 22, 2009, at 18:23:11
>
>
> I'm on zyprexa, abilify, tianeptine, high dose wellbutrin, memantine, sam-e, deplin, and tapering off of lithiumI'm very sorry. Very very sorry. For most of it, but not all of it. This brought you to God? That I am grateful for.
I look at the above list of meds and, well, I'm really sorry in advance, but all I can do is shake my head. No wonder you feel so bad.
Wellbutrin, bye bye. Memantine, bye bye. Deplin, bye bye. SAMe, keep 200mg a day or every other day. Tianeptine, bye bye. The toughest call are the antipsychotics. One of them has to go. Both are good ones. Tough call. Neither however has much antidepressant oomph without an SSRI, so without an SSRI or SNRI, you will get no use out of them and they are probably contributing to you feeling worse.
I hate to say it, but that entire cocktail has to go in the trash.
If it were me, I choose an SSRI or SNRI and a TCA. Anyone who knows me knows I'm thinking Effexor/Nortriptyline, Zoloft/Nortripline, any or all of them with Savella. I would probably do it cold turkey except for the antipsychotics, which I would have to juggle for a few months. Those would be the most treacherous and tricky to manage.
I am not at all suggesting you do these. I am only saying what I would do in your shoes. I have made huge dramatic moves like that when I was at a clear deadend. I did not want to put another one of those losers in my mouth one more time. They were not my friends, not helping me, maybe hurting me, and not welcome anymore.
Talk to God everyday. All the time. I have heard of God miraculously healing people. But I have never seen it. I have read about, but never seen it. I know HE can do it, but I've never seen it. It's all about faith. He wants us to have faith in Him. Now, if He shows us proof through a miracle we ask for, well, it isn't faith anymore.
Why does He allow us to stay ill? I'm certainly no Christian expert, but my basic beliefs are that God wants us desperately to choose Him over anything else in life. We are not to worship other idols, other Gods, other hobbies, medications, the ways of Satan, or anything. But it is our free choice. He doesn't force anything. He wants us to voluntarily choose His ways. By being in a bad place, which He didn't do...Satan did that, Satan invented depression...that is where we turn to God. If the only time we are going to turn to God is when we are at the bottom of the barrel, then that is where we will stay. God wants us to seek Him and be close to Him. He loves us and desperately wants us to come to Him. But if the only way that happens is when we are in a real bad place, then it is for our own eternal good that we stay in that bad place. That's why it is so important to talk with God all the time, good times, bad times, all the time.
This life doesn't matter. It is eternity that matters. As long as we are grasping for God during this life, we will see eternity in a place where there is no illness. If we have to leave this world ill, and that illness was the only way to keep us on the right path, then through all that badness there was actually profound goodness. This life is but a miniscule speck in time compared to what came before and what comes after.
Stay close to God, seek God all the time, and don't be surprised when He shows you some answers, some paths, some wisdom, some meds, some herbs, some visions,...that are customized just for you to feel better. If you start leaving Him, you'll probably start feeling worse. I can't explain it. That's just the way it is.
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